ArticleBMC public health2025
Community and health workers' perspective on impacts of climate change on reproductive, maternal, and child health outcomes in Kilwa district council, Tanzania: a qualitative study.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundClimate change continues to manifest at an unprecedented rate and is increasingly recognized as a serious threat to reproductive, maternal, and child health. This qualitative study aims to explore community and healthcare workers’ perspectives on the impacts of climate change and related extreme weather events on reproductive, maternal, and child health outcomes in Kilwa District, Tanzania.
methodsIn October 2024, a cross-sectional qualitative study design was employed where 10 focus group discussions with women and 15 key informant interviews with healthcare workers in 10 flood-prone villages in Kilwa District were conducted. All discussions and interviews were audio-recorded, transcribed verbatim, and analyzed using NVivo-12, both inductively and deductively.
resultsMost respondents perceive climate change as a shift in weather patterns over time, as evidenced by rising temperatures, unpredictable rainfall, and an increasing frequency of floods and tropical cyclones. High temperature, floods, and prolonged dry spells were perceived by community and healthcare workers to have direct and indirect impacts on reproductive, maternal, and child health outcomes. Study participants perceived a clear linkage between observed weather changes and negative maternal and child health outcomes, including limited accessibility to health facilities during the flooding season, a surge in climate-sensitive diseases such as malaria and diarrhoea in the aftermath of floods, and increased food insecurity leading to malnutrition. The increased frequency of climate-related disasters has driven changes in fertility intentions, as women have expressed a desire to have smaller families, fearing that climate-related extreme weather events would further strain their financial capacity to support larger families. Participants described that women faced heightened vulnerabilities due to patriarchal gender norms. Travelling long distances searching for water, increased burden of household chores, and climate-induced economic instability were reported to put women and girls at increased risk of experiencing sexual and gender-based violence. In response to these impacts, the community has implemented several adaptation measures such as utilizing maternity waiting homes during the flooding season, provision of psychosocial support for disaster victims, and relocation of vulnerable populations from flood-prone areas.
conclusionCommunity and healthcare workers' perspectives from this study highlight that the ongoing climate crisis is taking a heavy toll on reproductive, maternal, and children's health in Kilwa district. The findings underscore the critical urgency for strengthening the climate resilience of the healthcare system to ensure the continuity of healthcare service provision during and after climate-related disasters. Additionally, policy solutions are proposed to take into account the differential vulnerability and impacts of climate change, thereby ensuring climate action is gender-responsive.
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